Suicides surged in 2011 for the steepest increase in more than 13 years, according to a report released Friday by the state Department of Health. The total of 684 suicides was a 13 percent jump in a single year.

"We need to sound the alarm," said Jon Roesler, epidemiologist supervisor in the department's Injury and Violence Prevention Unit.

The alarm should be ringing loudest for white middle-aged men, he said. The suicide rate in that group is soaring, while the rate for teenagers is stagnant.

The 2011 numbers are the latest available.

Roesler said Minnesota's rates mirror national suicide rates, which show high suicide rates for white men. The federal Centers for Disease Control and Prevention reports that in 2010, white men had a suicide rate of 34 per 100,000 -- almost three times the overall average for Minnesota and the nation.

People who manage suicide hotlines are swamped with calls. The state hotline managed by Canvas Health of Oakdale handled 800 additional calls in 2012, manager Laura Weber said.

About 3,800 of the 39,000 calls were text messages, Weber said.

Texting is a new program, and an effective way for people to get help, she said. "It is geared to kids," she said. "People have the means, right in their hands."

As grim as the statistics are, Roesler said they contain some good news: Prevention programs seem to work.

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He said that in 2000, the state launched programs aimed at reducing suicides in teenagers and the elderly. Those rates have increased only slowly.

The new numbers, he said, show a need to apply the same urgency to middle-aged people.

The report contains other details of how and where Minnesotans kill themselves:

-- The suicide rate was 31 percent higher in rural areas than in the seven-county Twin Cities area.

-- In 55 percent of male suicides, guns were used. Poisons and overdoses were used in 47 percent of female suicides.

-- The male suicide rate in Minnesota was four times higher than the female rate.

Dan Reidenberg, director of Suicide Awareness Voices of Education of Bloomington, said suicides are twice as common as murders.

Suicides happen, he said, because of "multiple stressors" in a person's life -- such as the loss of a job, a failing marriage or health problems.

Mental illness also is a factor. As many as 95 percent of adults who kill themselves are mentally ill -- far higher than the 60 percent to 65 percent for youth.

In all suicides, hopelessness is an essential condition. "People with hope do not die of suicide," Roesler said.

Baby boomers, who are now middle-aged, have always had above-average suicide rates. Hotline manager Weber said they have a reputation for being more independent, separated from society and cynical about authority.

They tend to have a strong sensitivity to failure. So when a baby boomer loses a job, that person is more likely to consider suicide, she said.

"Typical is an older retired man who loved his job, and his kids don't need him any more," Weber said.

Men feel pressure not to fail at suicide, which is one reason they are more likely to use guns than pills.

The result, according to the department's report, is that the male suicide rate is 20 per 100,000 population, compared with 5 for women.

Women attempt suicide more often, however. For women, the leading cause of being hospitalized with an injury is attempted suicide, said Roesler.

"With women, it is the proverbial cry for help," he said. "Women can have more of a suicidal career."

But women do not have the same aversion to seeking professional help. "Women are more prone to talking about feelings," said Weber.

Suicides by young people are different.

Minnesota's suicide rate for people younger than 25 has stayed roughly level for 13 years and remains less than half the rate of older groups.

Weber said suicides happen when teens face a personal crisis that seems trivial to outsiders but is overwhelming to them. "They are in the flux of the trauma in their lives," Weber said.

The public response to teen suicides is intense. When a child dies, the grieving is public. Schools react to suicides with schoolwide counseling.

"Teens are prompted by their peers. They connect with services," Weber said.

It's much easier for a single middle-aged person to live a life of solitude and slide into depression without anyone intervening.

"Adults might not have any family," said Reidenberg of Suicide Awareness. "The media does not pay attention to them."